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DAILY NEWS ANALYSIS

  • 23 January, 2024

  • 5 Min Read

Anti-Microbial Resistance Cause and Solution

Recently the National Centre for Disease Control (NCDC) in a study found that over half of the nearly 10,000 hospital patients surveyed were given antibiotics to prevent, rather than treat, infection.

What is Antimicrobial Resistance (AMR)?

Antimicrobials - including antibiotics, antivirals, antifungals and antiparasitic - are medicines used to prevent and treat infections in humans, animals and plants.

  • It is defined as resistance of micro-organisms to an antimicrobial agent to which they were first sensitive.
  • Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.
  • Indian context- The present serious concern is that multiple types of bacteria like E. coli, Klebsiella, Acinetobacter, Staphylococcus aureus, enterococcus have even become resistant to some of the latest generation antibiotics.
  • AMR causes higher mortality and morbidity due to drug resistant infections.

What are the key highlights of the report?

India carries one of the largest burdens of drug-resistant pathogens worldwide.

Surveyed patients in %

Reason for antibiotic prescription

55%

Given prophylaxis as a preventive measure

45%

It is given to treat infections

6%

To identify the specific bacteria

What are the causes of AMR?

The World Health Organization (WHO) included AMR as one of the top 10 threats to public health in 2019.

  • Indiscriminate use- The inappropriate use of antibioticsin non-bacterial infections both because of prescribing practices and the use of over-the-counter antibiotics.
  • Lack of research- Inadequate laboratory facilities to inform clinicians rapidly about what would be an appropriate antibiotic even in bacterial infections, based on cultures.
  • Lack of capacity building- Due to lack of adequate training in antibiotic selection, escalation and de-escalation.
  • Lack of regulation- Inadequate monitoring of AMR and control of antibiotic and dispensing practices by health systems in spite of repeated warnings.
  • Market promotion- The pharmaceutical industry is incentivizing the antibiotic prescribing practices of doctors.
  • Superbugs- Inappropriate use of antibiotics and other molecules used to treat or prevent infections in the human, animal and agricultural sectors generate bugs that are resistant to these drugs.
  • Improper sanitation- This leads to the spread of superbugs due to inadequate infection prevention in healthcare institutions.
  • Lack of support- AMR is a complex socio-economic and political challenge and not just a scientific issue, it needs support from the pharmaceutical industry, awareness to the patients etc.,
  • Speedy treatment- The course of antibiotics is cheaper than the investigation of patients, which is time consuming.
  • Infrastructural deficit- India lacks laboratories to speed up the patient’s investigation making it costly, which results in over prescription of antibiotics.

What is the way forward?

  • Promote research- The need of the hour is linking labs to all levels of clinical setups and the fast transmission of infection-related data between the lab and the clinician.
  • Holistic approach- The rate of AMR is directly proportional to steady and strong governance, infrastructure, sanitation, poverty, access to clean drinking water, etc.,
  • Patient safety measures- The factors such as sanitation in hospitals, basic access to personal hygiene and infection control, are vital.
  • Enhance infection prevention- The basic steps such as washing hands regularly, use of sanitizers helped a lot to keep the infection under control during COVID-19, such practices must be adopted to prevent AMR.

Steps taken to control AMR

Global initiatives

  • Global Action Plan on AMR- It is committed to the development and implementation of multisectoral national action plans which was launched by the World Health Assembly in 2015.
  • World Antibiotic Awareness Week- A global campaign that aims to raise awareness of AMR worldwide.
  • Global Anti-Microbial Resistance and Use Surveillance (GLASS) – Launched by WHO in 2015 to strengthen AMR surveillance.
  • Muscat Ministerial Manifesto- It has 3 goals - to protect the efficacy of antimicrobials and curb the development of AMR worldwide, reduce environmental pollution and lower the spread of AMR.
  • Access, Watch and Reserve (AWaRe) – An initiative of WHO that takes into account the impact of different antibiotics.

India’s initiatives

  • National Action Plan on AMR (NAP-AMR) for 2017-2021 addresses 6 critical issues.
  • The country is in the process of updating its NAP-AMR for the period 2022-2026 through an extensive consultative process.
  • One health consortium- Country’s first one health consortium that enhance medical surveillance.
  • Delhi Declaration on AMR- A multi-sectoral initiative to recognize the emergence and spread of AMR and to adopt a collaborative approach for preventing AMR.
  • Indian priority pathogen list- Implemented to guide, research, discovery and development of new antibiotics.
    • Types of priority- Critical, High, Medium.
    • Example of critical priority- Colistin-R.
  • Red Line Campaign- Aimed at discouraging unnecessary prescription and over the counter sale of antibiotics.
  • Chennai Declaration- To formulate recommendations to tackle AMR.

Source: aspireias


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